Provider Demographics
NPI:1295700136
Name:KLOPP, EDWARD HENRY (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:HENRY
Last Name:KLOPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27496 COULBOURN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MARION STATION
Mailing Address - State:MD
Mailing Address - Zip Code:21838-2800
Mailing Address - Country:US
Mailing Address - Phone:410-623-2338
Mailing Address - Fax:410-623-2338
Practice Address - Street 1:100 EAST CARROLL STREET
Practice Address - Street 2:WOUND CENTER
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5493
Practice Address - Country:US
Practice Address - Phone:410-677-6605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD170332086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Not Answered208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
C57663Medicare UPIN